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"ABSTRACTIn the Introduction an explanation is given of the purpose of this study: firstly: to give a critical review of the case-histories of 40 patients, who in the period between the first of October 1954 and mid-February 1956 were operated upon in the "St. Borromeus Hospital" at Bandung with the resection-therapy for their tuberculosis of the lungs. Secondly : to present a discussion of the treatment of these patients before and after the operation; of the operative technique which I have used and of the many complications that followed. Thirdly : to venture a speculation as to the place, which the resection-therapy in the future may occupy in the treatment of tuberculosis of the lungs in Indonesia.Hereafter some considerations are given about the "lung-team" and about the difficulties and imperfections in the work at Bandung. :1.the scarcity of sufficient sanatorium-beds and our efforts towards a solution of this problem.2.the impossibility in Bandung of determining the resistance of the tubercle bacilli against the tuberculostatica.3.the impossibility of making bronchospirometrical researches of the function of the lungs.In Chapter I a description is given of the normal course of events in the St. Borromeus Hospital when a patient is taken into the hospital to undergo a resection operation. A detailed report is given of the technique of the operation. In the second part of this chapter a discussion is produced, starting with a review of the indications and contra-indications. Before discussing the scheme of indications an extensive review is made of the particular circumstances reigning in the field of the tuberculosis in Indonesia, which have in a considerable way influenced our indications.I deem the following 7 factors of the greatest importance1.The social circumstances of most of our tuberculous patients.2.The comparative scarcity of lung specialists in Indonesia.3.The comparative scarcity of available sanatoriumbeds.4.The impossibility of determining the resistance of tuberclebacilli against streptomycine, P.A.S. and T.N.H.5.The impossibility of making bronchospirometrical lung-function determinations.6.Our preference for resectiontherapy against thoracoplasty.7.The fear to operate in the case of bilateral tuberculous processes,when a longstanding observation of the patient by a lungspecialist has been impossible."

"[ABSTRAKPenyakit paru obstruktif kronik (PPOK) merupakan penyebab utama morbiditas dan mortalitas di dunia.Beberapa faktor risiko PPOK juga merupakan faktor risiko terjadinya tuberkulosis (TB).Beberapa penelitian di luar ditemukan prevalens TB paru pada pasien PPOK sekitar 2,6% - 10%.Indonesia khususnya di RSUP Persahabatan belum ada data proporsi TB paru pada pasien PPOK.Objektif: tujuan penelitian ini adalah mendapatkan angka proporsi TB paru pada pasien PPOK di RSUP Persahabatan Jakarta.Metode: desain penelitian ini adalah potong lintang. Pasien PPOK (belum diobati dengan obat anti tuberkulosis) yang berkunjung di poliklinik Asma/PPOK RSUP Persahabatan yang memenuhi kriteria inklusi dan eksklusi.Subjek diperiksa dahak BTA dan pemeriksaan Xpert MTB/RIF. Saat pasien berkunjung, dilakukan anamnesis gejala, eksaserbasi, riwayat merokok, penggunaan kortikosteroid (oral atau inhalasi), komorbid, skor CAT, penilaian status gizi, spirometri dan foto toraks. Semua data dilakukan analisis dengan uji chisquare.Hasil: subjek terbanyak adalah laki-laki (97,3%) dengan kelompok usia 60-79 tahun (74,3%), dengan komorbid terbanyak penyakit jantung (41,9%), gejala klinis terbanyak batuk berdahak (81,1%). Berdasarkan derajat PPOK terbanyak adalah GOLD 3 (44,6%) dan frekuensi eksaserbasi tersering 0-1 (78,4%) dengan menggunakan steroid sebanyak 59,5%. Pada penelitian ini didapatkan pemeriksaan dahak BTA positif 1,4% dan Xpert MTB/RIF positif 2,7%, artinya pemeriksaan Xpert MTB/RIF mempunyai angka kepositifan lebih tinggi dibanding dahak BTA. Dalam penelitian ini didapatkan proporsi TB paru pada pasien PPOK sebanyak 2,7%.Dalam Penelitian ini tidak terdapat hubungan bermakna secara statistik antara derajat PPOK, status gizi, penggunaan kortikosteroid, status merokok dengan prevalens TB paru pada pasien PPOK (p > 0,05).Pada penelitian ini didapatkan hubungan bermakna pada frekuensi eksaserbasi PPOK, hasil pemeriksaan dahak BTA dan hasil pemeriksaan Xpert MTB/RIF dengan proporsi TB paru (p < 0,05).Kesimpulan: proporsi TB pada pasien PPOK di RSUP Persahabatan Jakarta adalah 2,7%. Terdapat hubungan yang bermakna secara statistik antara frekuensi eksaserbasi PPOK dengan proporsi TB paru pada pasien PPOK (p = 0,0006). Terdapat hubungan yang bermakna secara statistik antara hasil pemeriksaan dahak BTA dan hasil pemeriksaan Xpert MTB/RIF dengan proporsi TB paru pada pasien PPOK dengan nilai p < 0,05 (p = 0,000).

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ABSTRACTChronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in the world. Some of the risk factors for COPD are also risk factors for tuberculosis (TB). Some studies abroad have found the prevalence of pulmonary tuberculosis in COPD patients were 2.6 - 10%. There are no data on the prevalence of pulmonary tuberculosis patients with COPD in Indonesia, particularly in The Department of Pulmonology PersahabatanHospital, Jakarta. Objective: the purpose of this study is to obtain proportion of pulmonary TB in COPD patients in The Department of Pulmonology Persahabatan Hospital, Jakarta. Methods: this is a cross-sectional study. COPD patients (anti-tuberculosis drugs naive) who visit the Asthma/COPD clinic PersahabatanHospital which meet the inclusion and exclusion criteria. Subjects went through acid-fast bacilli sputum smear and Xpert MTB/RIF examination. On patients visit, symptoms, exacerbations history, history of smoking, use of corticosteroids (oral or inhaled), comorbidities, CAT scores, assessment of nutritional status, spirometry and chest X-ray data had been obtained. All data were analyzed with chi-square test. Results: most subjects were male (97.3%) in the age group 60-79 years (74.3%), with mostly found comorbid was heart disease (41.9%), and mostly found clinical symptoms was productive cough (81.1%). Based on classification of COPD is GOLD 3 (44.6%) and the most exacerbation frequency was 0-1 (78.4%) with 59.5% history of steroid usage. In this study, examination of AFB sputum smear positive 1.4% and the Xpert MTB/RIF positive 2.7%, It shows Xpert MTB/RIF examination has a higher positivity rate than AFB sputum smear. The proportion of pulmonary tuberculosis in patients with COPD was 2.7%. We also found no statistically significant relationship between classification of COPD, nutritional status, use of corticosteroids, smoking status with the proportion of pulmonary tuberculosis in COPD patients (p> 0.05) but we found a significant difference in the exacerbations frequency of COPD, the results of sputum smear examination and the results of Xpert MTB/RIF with proportion of pulmonary TB (p <0.05).Conclusion: the proportion of tuberculosis in patients with COPD in The Department of PulmonologyPersahabatan Hospital Jakarta is 2.7%. There is astatistically significant difference between the frequency of exacerbations of COPD with proportion of pulmonary TB in patients with COPD (p = 0.0006). An association is statistically significant different between the results of sputum smear examination and the results of Xpert MTB/RIF with the proportion of pulmonary tuberculosis in patients with COPD with a value of p <0.05 (p = 0.000)., Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity andmortality in the world. Some of the risk factors for COPD are also risk factors fortuberculosis (TB). Some studies abroad have found the prevalence of pulmonarytuberculosis in COPD patients were 2.6 - 10%. There are no data on the prevalence ofpulmonary tuberculosis patients with COPD in Indonesia, particularly in The Departmentof Pulmonology Persahabatan Hospital, Jakarta. Objective: the purpose of this study is toobtain proportion of pulmonary TB in COPD patients in The Department of PulmonologyPersahabatan Hospital, Jakarta. Methods: this is a cross-sectional study. COPD patients(anti-tuberculosis drugs naive) who visit the Asthma/COPD clinic Persahabatan Hospitalwhich meet the inclusion and exclusion criteria. Subjects went through acid-fast bacillisputum smear and Xpert MTB/RIF examination. On patients visit, symptoms,exacerbations history, history of smoking, use of corticosteroids (oral or inhaled),comorbidities, CAT scores, assessment of nutritional status, spirometry and chest X-raydata had been obtained. All data were analyzed with chi-square test. Results: mostsubjects were male (97.3%) in the age group 60-79 years (74.3%), with mostly foundcomorbid was heart disease (41.9%), and mostly found clinical symptoms was productivecough (81.1%). Based on classification of COPD is GOLD 3 (44.6%) and the mostexacerbation frequency was 0-1 (78.4%) with 59.5% history of steroid usage. In thisstudy, examination of AFB sputum smear positive 1.4% and the Xpert MTB/RIF positive2.7%, It shows Xpert MTB/RIF examination has a higher positivity rate than AFBsputum smear. The proportion of pulmonary tuberculosis in patients with COPD was2.7%. We also found no statistically significant relationship between classification ofCOPD, nutritional status, use of corticosteroids, smoking status with the proportion ofpulmonary tuberculosis in COPD patients (p> 0.05) but we found a significant differencein the exacerbations frequency of COPD, the results of sputum smear examination andthe results of Xpert MTB/RIF with proportion of pulmonary TB (p <0.05). Conclusion:the proportion of tuberculosis in patients with COPD in The Department of PulmonologyPersahabatan Hospital Jakarta is 2.7%. There is a statistically significant differencebetween the frequency of exacerbations of COPD with proportion of pulmonary TB inpatients with COPD (p = 0.0006). An association is statistically significant differentbetween the results of sputum smear examination and the results of Xpert MTB/RIF with the proportion of pulmonary tuberculosis in patients with COPD with a value of p <0.05 (p = 0.000).]"

"IntroduksiHuman Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS), sejak dikenalnya sindrom penyakit ini lebih dari 2 (dua) dekade, terus menerus menyebar diseluruh dunia tanpa ada tanda-tanda pengurangan. Tuberkulosis (TB) merupakan penyebab utama kesakitan dan kematian pada orang dengan HIV/AIDS sekitar 40%-50%. Tujuan penelitian yaitu mengetahui kesintasan tiga tahun pasien HIV/AIDS dan pengaruh ko-infeksi TB terhadap kesintasan 3 tahun pasien HIV yang mendapat terapi ARV.MetodePenelitian ini adalah dengan pendekatan cohort retrospective di RSPI prof.dr. Sulianti Saroso Tahun 2009-2011.HasilProbabilitas kesintasan kumulatif pasien HIV/AIDS yang mendapat ART pada tahun pertama adalah 84,2%, 2 tahun adalah 81,4%, dan 3 tahun adalah 79,26%. Hasil analisis multivariate dengan uji regresi Cox Time Dependent Covariate menemukan koinfeksi TB mempengaruhi kecepatan kematian pasien HIV/AIDS (adjusted HR 1,60; 95% CI: 0,96-2,67) setelah dikontrol oleh faktor risiko penularan dan hitung CD4 sebelum terapi ARV. IDU memiliki pengaruh terhadap kesintasan tiga tahun pasien HIV/AIDS (aHR 1,71; 95% CI: 1,04-2,95). Apabila pajanan Koinfeksi TB dapat dieliminasi, maka sebesar 40% kematian pasien HIV/AIDS dapat dicegah di Rumah Sakit Prof. Sulianti Saroso.DiskusiPengaruh TB terhadap HIV, selain mempercepat progresivitas HIV juga berakibat pada mortalitas HIV. Koinfeksi TB menambah laju hazard terhadap ketahanan hidup pasein. Tingkat mortalitas pengidap HIV yang sekaligus mengidap TB 2 kali lebih tinggi dibandingkan dengan pengidap HIV tanpa TB.SaranMeningkatkan kualitas conselling kepada ODHA yang mendapat ART khususnya pada pasien dengan koinfeksi TB. Meningkatkan pogram kolaborasi TB-HIV di rumah sakit untuk menunjang efektifitas program dan pelayanan kesehatan kepada pasien HIV/AIDS.

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Introduction

Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV / AIDS), since this disease syndrome known more than two (2) decades, continuously spread throughout the world with no signs of abatement. Tuberculosis (TB) is a major cause of morbidity and mortality in people with HIV/AIDS around 40%-50%. The purpose of research is to determine the three-year survival rate of patients with HIV / AIDS and TB co-infection influences the 3-year survival of patients with HIV who receive antiretroviral therapy.

Methods:

This study is a retrospective cohort approach in RSPI Prof. Sulianti Saroso Year 2009-2011.

Results:

The cumulative probability of survival of patients with HIV / AIDS who receive antiretroviral treatment in the first year was 84.2%, 2 years was 81.4%, and 3 years was 79.26%. Results of multivariate analysis with the Cox regression Time Dependent covariate find TB affects the speed of death in HIV / AIDS (adjusted HR 1,60; 95% CI: 0,96-2,67)) after controlled by transmission risk factors and CD4 counts before ART. IDU patients had 2 times the risk of a hazard than patients with non-IDU group (adjusted HR 1.95, 95% CI: 1.17 to 3.24). If TB Co-infection can be eliminated from th e susceptible population, then the death of 40% of patients with HIV/AIDS can be prevented in the Infectious Disease Hospital Prof. dr. Sulianti Saroso.

Discussions:

Effect of TB to HIV, besides accelerating the progression of HIV also result in mortality of HIV. TB adds to the hazard rate of survival pasein. The mortality rate of people with HIV who also have tuberculosis 2 times higher compared to HIV without TB.

Recommendations:

Counselling to improve the quality of people living with HIV who received antiretroviral therapy, especially in patients co-infected with TB. Increase pogram TB-HIV collaboration at the hospital to support effective programs and health services to patients with HIV / AIDS."

"Penyakit Tuberkulosis merupakan penyakit infeksi kronis masih menjadi masalah kesehatan masyarakat di dunia termasuk Indonesia.WHO mengestimasi rata-rata kasus untuk pemeriksaan dahak didapatkan BTA positif 115 per 100.000 tahun 2003. Jumlah kasus baru TB Paru BTA positif sebesar 194.780 orang tahun 2011, untuk kabupaten Bogor tahun 2010 sebanyak 3.869 orang dan Kecamatan Cisarua 18 orang.Manajemen penyakit Tuberkulosis berbasis wilayah dilaksanakan dengan manajemen kasus dan manajemen faktor risiko secara simultan, paripurna, terencana dan terintegrasi. Penelitian ini mengenai analisis manajemen penyakit TB berbasis Wilayah di Kecamatan Cisarua Kabupaten Bogor tahun 2012.Kerangka konsep penelitian ini menggunakan pendekatan manajemen penyakit berbasis wilayah dengan memadukan manajemen kasus dengan manajemen faktor risiko. Penelitian ini dilakukan dengan metode kualitatif. Hasil penelitian menunjukan bahwa UPT Puskesmas Cisarua telah melaksanakan manajemen kasus pada penanggulangan penyakit Tuberkulosis melalui program DOTS, namun upaya penanggulangan faktor risiko belum optimal. Tidak ada Klinik Sanitasi sebagai suatu wahana masyarakat dalam mengatasi masalah kesehatan lingkungan.

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Tuberculosis is a chronic infectious disease remains a public health problem in the world including Indonesia.WHO estimating the average case for smear-positive sputum specimens obtained 115 per 100,000 in 2003. Number of new cases of smear-positive pulmonary TB 194 780 people in 2011, to the district of Bogor in 2010 and as many as 3,869 people Cisarua District 18.

Tuberculosis disease management implemented region-based case management and management of risk factors simultaneously, complete, well-planned and integrated. This study analyzes the management of TB disease in the sub region based Cisarua Bogor regency in 2012.

The conceptual framework of this study using area-based disease management approach to integrating case management with risk factor management. This research was conducted with qualitative methods. The results showed that the UPT Puskesmas Cisarua been implementing case management on tuberculosis control through DOTS programs, but the reduction of risk factors is not optimal. No Sanitation Clinic as a vehicle for communities to address environmental health issues."

"Skripsi ini membahas terjadinya peningkatan kejadian kasus Tuberkulosis paru BTA (+) di Kota Sukabumi dan belum diketahuinya pola penyebaran penyakit Tuberkulosis paru BTA (+) dengan analisis spasial berdasarkan faktor kependudukan dan pelayanan kesehatan, bertujuan untuk mengetahui analisis spasial kejadian Tuberkulosis paru BTA (+) di Kota Sukabumi tahun 2010-2012. Penelitian menggunakan desain studi ekologi jenis multiple group dengan time trend menggunakan pendekatan analisis spasial. Hasil penelitian bahwa kasus baru dan insiden Tuberkulosis paru BTA (+) di Kota Sukabumi tahun 2010-2012 meningkat dan cenderung mengikuti pola persebaran kepadatan penduduk, jumlah fasilitas pelayanan kesehatan dan jumlah tenaga kesehatan. Dari hasil penelitian ini menyarankan agar program pemberantasan dan pengendalian penyakit Tuberkulosis paru BTA (+) sebaiknya diprioritaskan pada wilayah dengan kepadatan penduduk tinggi.

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This essay discusses the increased incidence of pulmonary Tuberculosis cases of Acid-Resistant Bacteria (+) in Sukabumi and not knowing the pattern of spread of disease pulmonary Tuberculosis Acid-Resistant Bacteria (+) with a spatial analysis based on demographic factors and health services, spatial analysis aimed to determine the incidence of pulmonary Tuberculosis Acid–Resistant Bacteria (+) Sukabumi in 2010-2012. Research design using multiple types of ecological study group with a time trend using spatial analysis approach.

The results of that study and the incidence of new cases of pulmonary Tuberculosis Acid–Resistant Bacteria (+) in Sukabumi in 2010-2012 increased and tend to follow the pattern of distribution of population density, the number of health care facilities and health workers. From the results of this study suggest that eradication programs and disease control pulmonary Tuberculosis Acid–Resistant Bacteria (+) should be prioritized in areas with high population density."

"Tujuan penelitian ini adalah untuk melihat pengaruh pemberian biskuit tempe terhadap status gizi balita tuberkulosis. Penelitian ini menggunakan desain kuasi eksperimental. Kelompok perlakuan (n=12) diberikan biskuit tempe sebanyak 50 gram setiap hari selama satu bulan, sedangkan kelompok kontrol (n=5)adalah balita yang diberikan biskuit plasebo 50 gram. Hasil penelitian menunjukkan ada perubahan yang signifikan pada berat badan dan status gizi sebelum dan sesudah intervensi pada kelompok perlakuan (p<0,05), tetapi tidak pada kelompok kontrol (p>0,05). Tidak ada perbedaan perubahan berat badan dan status gizi balita antara kelompok perlakuan dan kontrol (p>0,05).

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The purpose of this study was to see the effect of giving tempeh biscuit nutritional status of under five children with tuberculosis. This research uses quasi-experimental design. Treatment groups (n=12) were given 50 grams tempeh crackers every day for a month, whereas the control group (n=5)infants given placebo biscuits 50 grams.

The results showed significant changes in body weight and nutritional status before and after intervention in the treatment group (p <0.05), but not in the control group (p> 0.05). There was no difference in weight change and nutritional status of children between the treatment and control group (p>0,05)."

"Indonesia masih mempunyai banyak masalah kesehatan, salah satunya adalah mengenai penyakit infeksi. Salah satu masalah terbesar adalah penyakit tuberculosis (TB). Indonesia menduduki peringkat kelima negara dengan penderita TB terbanyak. Banyak cara telah dilakukan untuk menanggulangi masalah tersebut, misalnya aplikasi Strategi DOTS. Namun tampaknya hal ini belum cukup adekuat untuk mengatasi penyakit TB mengingat semakin meningkat angka penderita TB. Keadaan ini diperburuk dengan insiden koinfeksi TB dan HIV. Tujuan penelitian ini adalah mengetahui ada tidaknya hubungan yang berbeda bermakna antara tingkat pendidikan formal, pekerjaan sehari-hari, tingkat pengetahuan ibu, sikap ibu terhadap penderita TB dan kesediaan ibu menjalani pengobatan TB terhadap persepsi ibu mengenai penyakit TB. Data diambil pada 1 Maret 2011 sampai 1 Mei 2012 di Jakarta Timur. Dari 2415 responden yang berhasil diwawancarai terdapat 2395 responden yang memenuhi kriteria. Dari 2395 responden, sebanyak 1098 responden (45,85%) mempunyai pandangan bahwa penyakit TB adalah penyakit yang memalukan. Tingkat pendidikan formal terakhir ibu yang paling banyak adalah setidaknya SMA (52,7%). Kebanyakan ibu tidak bekerja atau beraktivitas sebagai ibu rumah tangga sehari-harinya (68,73%). Tingkat pengetahuan ibu terhadap TB adalah tinggi sebanyak 57,83%. Dengan uji chi-square didapatkan bahwa tidak terdapat hubungan berbeda bermakna antara pekerjaan dan persepsi ibu (p=0,829). Sedangkan dengan uji yang sama terdapat hubungan berbeda bermakna antara pendidikan, pengetahuan, sikap ibu terhadap penderita TB, kesediaan menjalani pengobatan dengan persepsi ibu terhadap penyakit TB (p<0,01).

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Indonesia still has a lot of health problems, one of which is the infectious disease. One of the biggest problems is TB. Indonesia was ranked the fifth largest country with TB. Many ways have been made to overcome these problems, such as applications DOTS strategy. But apparently this has not been adequate enough to cope with TB given the ever increasing number of TB patients. This situation is exacerbated by the incidence of TB and HIV co infection. The purpose of this study was to determine whether there are significantly different relationship between the level of formal education, daily work, the level of knowledge of mothers, maternal attitudes toward people with TB and the willingness of women undergoing treatment for TB of the mother's perception of TB. Data was taken on March 1, 2011 until May 1, 2012 in East Jakarta.

From 2415 respondents were successfully interviewed 2395 respondents found that suitable with the criteria. Of the 2395 respondents, a total of 1098 respondents (45.85%) had the view that TB is a shameful disease. Last formal educational level of mothers is at least senior high school (64.51%). Most mothers do not work or activities as a housewife daily (68.73%). Mother's level of knowledge of TB is high as 57.83%. With chi-square test found that there was no difference between the employment relationship and the perception of the mother (p = 0.829). Whereas the same test are significantly different relationship between education, knowledge, attitudes toward people with TB mother, a willingness to undergo treatment with the mother's perception of TB disease (p <0.01)."

"Tuberkulosis (TB) adalah penyakit menular yang disebabkan oleh Mycobacterium tuberculosis (MTB) dimana umumnya menyerang paru-paru. Salah satu faktor yang mengakibatkan tingginya kasus TB di dunia yaitu pengidap TB bisa mengalami kekambuhan TB yaitu relapse dan reinfeksi. Upaya pemerintah untuk mengendalikan penyebaran TB yaitu dengan menjalankan program "Gerakan Bersama Menuju Eliminasi TB 2030" dimana selain berfokus pada pengobatan TB, program ini juga berfokus pada pencegahan TB. Dalam skripsi ini dilakukan analisis model penyebaran TB dengan pengaruh relapse dan reinfeksi untuk memahami dinamika penyebaran TB dan menentukan solusi yang efektif dalam menanggulangi TB. Untuk mewakili kondisi di lapangan, pada skripsi ini dipertimbangkan kesadaran masyarakat untuk melindungi dirinya dari TB. Pada skripsi ini dilakukan pula penaksiran parameter dengan menggunakan data kuartal kumulatif kasus baru TB yang terdeteksi di Indonesia pada tahun 2017 hingga 2021. Berdasarkan nilai estimasi parameter tersebut diperoleh nilai R0 = 1.082593215 > 1 yang mengindikasikan bahwa seiring berjalannya waktu penyakit TB terus menyebar dan menjadi endemik. Selanjutnya, berdasarkan analisis titik keseimbangan diperoleh fenomena bifurkasi maju dan bifurkasi mundur pada R0 = 1. Sehingga, kondisi R0 < 1 tidak dapat dijadikan sebagai indikator hilangnya penyakit TB di dalam populasi. Selanjutnya dilakukan simulasi numerik dan diperoleh bahwa dengan menurunkan laju relapse TB dan meningkatkan laju kesembuhan TB mampu untuk mereduksi penyebaran TB.

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Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis (MTB) which generally attacks the lungs. One of the factors that causes the high number of TB cases in the world is that people with TB can experience TB recurrence, namely relapse and reinfection. The government’s effort to control the spread of TB is by running the program "Joint Movement Towards TB Elimination 2030" where in addition to focusing on TB treatment, this program also focuses on TB prevention. In this study, an analysis of the TB spread model with the effect of relapse and reinfection is carried out to understand the dynamics of the spread of TB and determine an effective solution in tackling TB. To represent the real conditions, this study considers public awareness to protect themselves from TB. In this study, parameter estimation is also carried out using cumulative quarterly data of new TB cases detected in Indonesia from 2017 to 2021. Based on the estimated value of these parameters, the value of R0 = 1.082593215 > 1 indicates that over time TB disease continues to spread and become endemic. Furthermore, based on the analysis of the equilibrium point, the phenomenon of forward bifurcation and backward bifurcation is obtained at R0 = 1. Thus, the condition of R0 < 1 cannot be used as an indicator of the disappearance of TB disease in the population. Furthermore, numerical simulations were carried out and we concluded that by reducing the rate of TB relapse and increasing the TB cure rate are able to reduce the spread of TB."

"Tuberkulosis (TB) masih merupakan masalah kesehatan di dunia serta muncul ke permukaan sebagai penyebab utama kematian. Saat ini TB telah menjadi ancaman global, World Health Organization (WHO) memperkirakan terdapat 8 juta kasus baru dan 3 juta kematian karena TB setiap tahunnya. Pada tahun 1990 dilaporkan. hampir 3,8 juta kasus TB di dunia dan 49%nya terdapat di Asia Selatan dan Timur, diperkirakan pula bahwa 1,7 miliar penduduk pada tahun 1990 (sekitar 1/3 penduduk dunia) terinfeksi Mycobacterium tuberculosis (M.tuberculosis).Menurut WHO pada tahun 1998 Indonesia menempati urutan ketiga dalam jumlah penderita TB terbanyak di dunia setelah India dan China. Diperkirakan pada tahun 2000 ditemukan 1.856.000 kasus baru di India (WHO Report 2002), 1.365.000 kasus baru di China dan 595.000 kasus baru di Indonesia.dikutip dari The World Health Organization dalam Annual report on global TB control 2003 juga menyatakan terdapat 22 negara dikategorikan sebagai high burden countries terhadap TB. Indonesia masih tetap peringkat ketiga setelah India dan China dalam menyumbang jumlah kasus TB di dunia. Estimasi prevalens TB di Indonesia tahun 2003 adalah 295 per 100.000. Indonesia kemudian melakukan survei prevalens TB tahun 2004, mencakup 30 provinsi yang memberikan estimasi prevalens TB berdasarkan pemeriksaan mikroskopik BTA positif sebesar 104 per 100.000. Prevalens TB di Jawa Bali sebesar 59 per 100.000 jauh lebih rendah dibanding luar Jawa Bali 174 per 100.000."

"Latar belakang pendidikan dan pengetahuan mengenai Tuberkulosis (TB) merupakan salah satu faktor yang dapat mempengaruhi konversi sputum TB. Studi ini bertujuan untuk mengetahui hubungan antara level edukasi pasien dan tingkat pengetahuan tentang TB dengan konversi sputum pada dua bulan.Studi potong lintang ini di lakukan di Rumah Sakit Persahabatan dengan menganalisa latar pendidikan dan pengetahuan mengenai TB. Dari 106 pasien (63 laki-laki, 43 perempuan) dengan rentang umur 20-65 tahun dilakukan interview langsung dan pengisian kuesioner untuk mengetahui tingkat pendidikan dan pengetahuan akan TB. Uji sampel chi-square digunakan untuk menilai signifikansi statistik pada penelitian ini. Terdapat hubungan yang bermakna antara latar pendidikan dan pengetahuan mengenai TB (p<0.05); pendidikan dan sputum konversi (p<0.05). Tidak terdapat nilai statistic yang signifikan antara pengetahuan TB dan sputum konversi (p>0.05). Hasil penemuan studi ini menunjukan bahwa latar pendidikan yang lebih tinggi berhubungan dengan tingkat pengetahuan TB dan sputum konversi yang lebih baik. Akan tetapi, tingkat pengetahuan TB yg lebih baik tidak menunjukan bahwa pasien memiliki konversi sputum yang positif pada dua bulan.

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Educational backgrounds and level of knowledge are factors that might affect the sputum conversion of the Tuberculosis (TB) patients. This study focused to investigate the association between educational background and level of knowledge of the TB patient and the sputum conversion at two months. This cross-sectional study was done in Persahabatan hospital among 106 patients (63 male, 43 female) with the age ranging from 20-65 years old. The educational background and knowledge level of TB were assessed using a questionnaire and direct interview. A chi- square test was conducted to assess the association between knowledge level of TB and education level, education level and sputum conversion, and knowledge level of TB and sputum conversion. There were a statistically significance association between education level and knowledge about Tuberculosis (p<0.05); education level and sputum conversion (p<0.05); however, knowledge level of TB and sputum conversion were not statistically significant (p > 0.05). These findings suggest that the higher the education, the higher the patient's knowledge level of TB and sputum conversion rate. However, higher knowledge level of TB does not necessary mean that the patient will have a positive sputum conversion at two months."